[Benign tumors of the liver. hemoperitoneum caused by rupture of a hepatic adenoma].
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Biomedical subjects
Publications and source records attributed to B Descottes.
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After a recall of muscular histo-enzymology, the authors expose the results of an analysis of the antero-lateral muscles of the abdomen. They establish a predominance of the muscular fibers, type I, that are tonic as compared with the muscular fibers, type II, that are phasic. Thus the role of support and of maintenance of the intra-peritoneal pressure by these muscles is confirmed. The tonic characteristic is also important for the functional reeducation and the electrotherapy of the abdominal wall.
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The studies of the levels of the CEA and of the beta2m were both performed on 52 patients. The authors pointed out the interest of measurement of these 2 markers and above all the interest of their complementary before any therapy and during treatment by surgery or radiotherapy whether associated or not.
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We report a case of postoperative inferior mesenteric arteriovenous fistula. Arteriovenous fistula represents a rare disease. Symptoms are due to portal hypertension and distal ischemy. Treatment of these fistulas is embolization. Surgery is possible by ligature or excision of the fistula because vascularisation is obtained by Riolan arcade and hypogastric artery.
The cecum is the second most common site of colonic volvulus after the sigmoid. The mechanism is torsion or hyperflexion of the enlarged, poorly-fixed, and hypermobile cecum. It presents clinically as an acute bowel obstruction with strangulation. Diagnosis can be made by plain abdominal X-ray in more than half the cases on the basis of cecal distention (with a classical "teardrop" or "comma" appearance), proximal small bowel distention with air-fluid levels, and a gasless distal colon. Barium enema shows lack of filling of the cecum, often with a "beaked" termination of the column of contrast. CT images are pathognomonic when they reveal a cecal "vortex". After surgical reduction of the torsion, ileo-cecal resection is usually the best therapeutic alternative. Cecopexy may be aDDrouriate in older and debilitated Datients if there is no concomitant cecal necrosis.
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Lipiodol Ultra-Fluid (LUF), a contrast medium for the diagnosis and treatment of hepatocellular carcinoma (HCC), is used by hepatic intra-arterial infusion. Hepatoma cells are capable of active uptake of LUF and retaining it for prolonged periods of time. These characteristics have important therapeutic potential for the targeting of anticancer drugs and have lead us to form an intratumoral diffuser. But, before in vivo studies, we have investigated in vitro LUF effects on various cell species in order to explain and refine the lipiodol chemotherapy. The antiproliferative and cytotoxic effects of LUF on HepG2 (human hepatoma cells), MCF-7 (human breast cancer cells) murine macrophages and human hepatocytes, were assessed by Trypan blue exclusion and lactico-dehydrogenase extracellular tests. We demonstrated the dose and time-dependent antiproliferative and cytotoxic activities of LUF on cells. Cytotoxicity was different according to cells species, whether or not they had cancerous characteristics and phagocytosis function: this cytotoxicity was very significant on macrophages and was greater for cancerous cells than for human hepatocytes in primary culture. We showed in vitro, for the first time, that LUF was an antiproliferative and cytotoxic agent, because of its active uptake and selective retention which lead to cellular death due to necrosis by lipoperoxidation increase.
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Fibrin sealant is widely used to achieve complete hemostasis in many fields of surgery. A retrospective review of the surgical management of 81 patients with thyroid diseases between 1992 and 1998 was undertaken to determine if drainage after thyroid surgery could be safely avoided and substituted by fibrin sealing before closure of the wound. Complications were few and resulted in one patient with hoarseness, four minor oedemas and one case of unexplained fever during 48 h. The subjective discomfort from the collar incision was unusual and aesthetic healing was obtained in most of the cases (93.8%). These results suggest that the application of fibrin sealant can be advocated in thyroid surgery as an adjunct to a good surgical procedure and perhaps that prophylactic drainage is unnecessary.
The authors report 55 cases of primary neoplasms of the bladder which represent 5,2 per cent of cholecystectomies, their study prove its very important deadly character. They insist on the necessity of the immediatly systematic examination. This examination permit a knowledge of the in situ stades and permit to make adapted surgical treatment. This treatment may be a cholecystectomy if it's a in situ type adenocarcinoma but it must be an enlarged cholecystectomy in all the other cases.
The authors report one case of double spontaneous viscerorenal fistula on the right kidney. After consultation of the world literature, they expose the main character of this lesion. They insist on the transparietal pyelography in the diagnosis and on the surgical treatment.
There is an important fistula rate associated with the cervical anastomosis of oesophagoplasties. The authors report their experience with reinforcement of these anastomoses by adhesion using a fibrinogen based biological tissue glue. They propose that this technique be used in all high risk anastomoses, in particular, for those affecting a non peritonealized section of the digestive tract.